Manually operated medical and surgical instruments provide surgeons with the capability of emplacing or removing sutures. Some of the devices enable surgeons to grasp suture needles within the procedural field. These instruments have jaws at the distal end, which allow the needle to be trapped and removed. Surgeons utilize these various devices when there is limited accessibility within the procedural field. To alleviate large incisions, which involve a higher morbidity due to increased trauma to surrounding tissue and a higher incidence of complications, endoscopic procedures have become preferable methods of accessing various surgical sites. The suture devices are utilized in endoscopic procedures in order to achieve hemostasis after the removal or biopsy of an organ.
The instruments that are typically used to suture tissue in these confined sites are needles inserted through a trocar sheath or devices in which a retractable needle is encased in a cannula. The needle on these devices typically penetrates entrappod tissue. The hook on the needle snares the sutures in the recess and the needle is retracted back through the tissue. These devices are bulky, and force is often necessary to engage the suture. Tissue can be dense and difficult to penetrate with a needle. In some of the instruments that are elongated to reach the surgical or biopsy site, the shaft and posts are not rigid enough to endure the force that must be applied to penetrate the tissue. Many times this force is necessary because the needle is not sharp enough to easily pierce the dense tissue. The instruments are sometimes heavy and burdensome, which restricts the surgcon's maneuverability and causes fatigue. Use of undue force in the suturing procedure retards healing, and large needle heads and cannulas restrict the physician's vision. Also, the instruments are often not sufficiently elongated to accommodate adequate retrieval or rotation of the suture material.
A known ligature provides a series of gauged needle sizes that allow suturing of tissue. However, these needles are used primarily in shoulder surgery due to the length of the devices. This ligature is designed with a sliding member that is unstable due to friction encountered during penetration into the tissue. The distal end of the ligature includes a recess that holds the suture in place. The friction encountered during penetration forces the recess open, exposing sharp edges that sever tissue. The prior art is not well suited for endoscopic surgery and cannot be adapted to these procedures without compromising the integrity of the stainless steel shaft and post on the instruments.
German Patent 2,532,242 illustrates a fixed rounded needle having an internal sleeve which is shiftable to engage a suture in a cut-out within the needle. However, the opening for entry of the suture remains exposed due to the track for the internal sleeve leaving notches open on the periphery of the stationary needle. These open notches can engage the tissue and cause trauma.
Accordingly, it is an object of this invention to provide surgeons with a device that minimizes trauma to tissue during the suturing procedure. The present invention provides a needle with a hook that recedes into a protective sheath, which allows accomplishment of the above objective.